Abstract
Low bone mass as estimated by decreased bone mineral density (BMD) is an established predictor of osteoporotic fractures. One of the latest developments in bone densitometry is peripheral quantitative computed tomography (pQCT) of the forearm. In Germany, the CT bone scanner XCT 900 has already been widely used; however, interpretation of measurements with respect to osteoporosis risk assessment can be improved by better defined and validated reference data. In the present study, this device was used to measure BMD at the distal radius in a well-defined healthy population of 179 German adults (91 men, 88 women) aged 20–79 years. In vivo precision was 1.67% for trabecular and 0.81% for total BMD measurements. Peak values of trabecular and total BMD were observed at the ages 40–50 years in women and 30–40 years in men. Beyond these ages, both trabecular and total BMD showed a linear decline with age, decreasing by 0.85% and 1.08% per year in women and by 0.59% and 0.54% in men, respectively. Measures of BMD were not influenced by weight, height or body mass index (BMI). In both sexes, trabecular and total radial BMD showed a positive and significant correlation with femoral BMD measures obtained by dual X-ray absorptiometry (DXA). Weaker correlations were observed with DXA measures of the lumbar spine. Compared with the 95% reference range provided by the manufacturer, the distribution of age- and sex-specific values of trabecular BMD of the distal radius was shifted to lower values by up to 1 standard deviation. Thus, 17% (30 of 179) of our apparently healthy population had BMD values falling short of the suggested lower reference limit. On the other hand, the distribution of total BMD values was shifted to higher values by up to 2 standard deviations in the younger age groups. We conclude that pQCT of the radius is a precise method for measuring BMD, but that its use for osteoporosis risk assessment crucially depends on both well-defined reference data and the results of prospective studies.
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References
Reiners C. Nicht-invasive quantitative Knockendichtebestimmung. In: Ringe JD, editor. Osteoporose. Berlin: de Gruyter, 1991:157–216.
Need AG, Nordin BEC. Which bone to measure? Osteoporosis Int 1990;1:3–6.
Schneider P. Börner W. Periphere quantitative Computertomographie zur Knochenmineralmessung mit einem neuen speziellen QCT-Scanner. ROFO 1991;154:292–9.
Düppe H, Gärdsell P, Johnell O, Nilsson BE. Bone mineral content in women: trends of change. Osteoporosis Int 1992;2:262–5.
Rüegsegger P, Durand E, Dambacher MA. Localisation of regional forearm bone loss from high resolution computed tomographic images. Osteoporosis Int 1991;1:76–80.
Schneider P, Börner W, Lehmann R, et al. Deutsches Referenzkollektiv fur die Knochendichtebestimmung mit der pQCT am Radius. Presentation at the 31st International Symposium of the German Society of Nuclear Medicine 1993, abstract no. V149.
Lehmann R, Kvasnicka HM, Wapniarz M, et al. Overestimation of osteopenia using standard analysis software for peripheral quantitative computed tomography. Clin Investig 1993;71:600–3.
Wüster C, Duckeck G, Ugurel A, et al. Bone mass of spine and forearm in osteoporosis and in German normals: influence of sex, age and anthropometric parameters. Eur J Clin Invest 1992;22:366–70.
Mazess RB, Barden HS. Interrelationships among bone densitometry sites in normal young women. Bone Miner 1990;11:347–56.
Lehmann R, Wapniarz M, Kvasnicka HM, et al. Reproduzierbarkeit von Knochendichtemessungen am distalen Radius mit einem hochaufl ösenden Spezialscanner für periphere quantitative Computertomographie (Single Energy PQCT). Radiologe 1992;32:177–81.
Wüster C, Bockmühl M, Ugurel A, et al. Normal values for bone mineral content (BMC) as measured by dual-photon and dual-x-ray absorptiometry (DPA vs DPX). Calcif Tissue Int 1991;48 Suppl:A77.
Grimston SK, Morrison K, Harder JA, Hanley DA. Bone mineral density during puberty in Western Canadian children. Bone Miner 1992;19:85–96.
Schneider P, Börner W, Mazess RB, Barden H. The relationship of peripheral to axial bone density. Bone Miner 1988;4:279–87.
Cummings SR, Black DM, Nevitt MC, et al. Bone density at various sites for prediction of hip fractures. Lancet 1993;341: 72–5.
Gärdsell P, Johnell O, Nilsson BE. Predicting fractures in women by using forearm bone densitometry. Calcif Tissue Int 1989;44:235–42.
Cummings SR, Black DM, Nevitt MC, et al. Appendicular bone density and age predict hip fracture in women. JAMA 1990;263:665–8.
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Butz, S., Wüster, C., Scheidt-Nave, C. et al. Forearm BMD as measured by peripheral quantitative computed tomography (pQCT) in a German reference population. Osteoporosis Int 4, 179–184 (1994). https://doi.org/10.1007/BF01623237
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DOI: https://doi.org/10.1007/BF01623237